Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Benjamin Michael Moreau, PA

Individual provider Physician Assistant · NPI 1215627575

Benjamin Michael Moreau, PA is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2023, 3 years ago. Practices with Bellin Memorial Hospital Inc, a 681-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Michigan and Wisconsin.

Years since qualifying
3
Licensed in
MI, WI
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone: (920) 430-4888
Fax: (920) 430-4889
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 610 S Lincoln Rd, Escanaba, MI 49829-1215 — (906) 786-6488
  • 440 Woodward Ave, Iron Mountain, MI 49801-4631 — (906) 776-9040
  • 2820 Roosevelt Rd, Marinette, WI 54143-3834 — (715) 735-5225
  • 507 North 17th Street, Milwaukee, WI 53233 — (414) 288-5688

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7440-23 (WI)
Physician Assistant Taxonomy 363A00000X · Licence 5601011806 (MI)

Record details

NPI number1215627575
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 10, 2023
Last updated in NPPESAugust 31, 2023
Certification dateAugust 31, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Bellin Memorial Hospital Inc — 681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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